Care Home: Westbourne

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What the care home does well Perhaps the best assessment of the home is the following comment from a regular visitor; "Westbourne seems to be fulfilling its purpose admirably and of all the residential homes I have visited, I`d probably choose to go here because it is smaller than most and the staff seem to really care". Two comments received from different health care professionals are equally positive; ""Provides an excellent, caring and professional environment for residents" and "Provides excellent residential care for residents with supportive and informed staff". These views were supported by other surveys returned to us and from comments received on the day of the inspection. They were also confirmed by the evidence we saw in records and whilst observing the care provided to people living in the home. The staff team and the managers on duty were not only helpful and co-operative, which might be expected during an inspection but were utterly committed and enthusiastic about their jobs and the standard of care they provided. "We are proud of what we do" and "I am very happy working here" were just two of the positive comments received when talking to care staff. The home`s environment has been significantly improved with work carrying on during the inspection to increase the number of bedrooms with en-suite facilities and there have been improvements to the kitchen in particular and also to the garden. What has improved since the last inspection? In their AQAA the home identify improvements in the environment as above together with important improvements to the way care and systems are monitored. This has resulted in an overall improvement to medication records and practice and to staff training and supervision records as well as to care plans, all of which are now completed to a high standard. One particular feature of the home that drew special comment was the improvements to the activities available, including the availability of Internet access for people living in the home and the use of a WII in the home`s activities. What the care home could do better: The home identifies the need to sustain quality as its priority and mentions for example the need to make information about the home available in large print formats to improve access for people for whom that would be helpful. There are no requirements made following this inspection and that reflects what was an overwhelmingly positive process. Over the past four years in particular, Westbourne has been set on a path of significant, incremental improvement that has seen it progress to the new assessment that it provides excellent care outcomes for the people who live there. This has only been achieved through the dedication and hard work of all the people associated with the home, including the proprietors. The challenge for the future is to both maintain, sustain and take forward the standard of care outcomes achieved. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westbourne 9 Bedford Road Hitchin Hertfordshire SG5 2TP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jeffrey Orange     Date: 1 0 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Westbourne 9 Bedford Road Hitchin Hertfordshire SG5 2TP 01462459954 F/P01462459954 angela.bowes@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Balbir Bains,Mrs Kulvinder Kaur Bains care home 27 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Only bedrooms 4 and 15, which measure 17.5 square metres, can each be shared by 2 persons through positive choice and mutual agreement. Date of last inspection Brief description of the care home Westbourne is a large detached two-storey house, situated close to the centre of Hitchin, which has been converted for use as a care home for elderly people. The original house was built in 1859 and has been extended. It has a total of twenty six bedrooms, one of which can be shared by two people through positive choice and mutual consent. The ground floor has an entrance lobby, two lounges to the front, one lounge, one dining room and a conservatory to the rear, the main kitchen, an office and eight bedrooms, all of which have en-suite wash hand basins and toilet and two of which also have showers. There is also one assisted bath. The laundry is situated in Care Homes for Older People Page 4 of 26 Over 65 27 0 Brief description of the care home the basement. A passenger lift serves the first floor. The first floor has eighteen bedrooms, five with wash hand basins only, eight with en-suite wash hand basin and toilet and five with showers in addition. There is a hip- bath and two assisted baths. There are gardens to the front and rear of the home with parking available at the front of the home. The home has a statement of purpose and service user guide to provide information to prospective service users and copies of the latest inspection report from the Care Quality Commission(CQC) are also available in the home. Current charges range from £437- £595 per week. Additional charges apply for chiropody, dentistry and opticians services and for newspapers, hairdressing and personal toiletries. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection of this service was on the 15th August 2007 when it was rated as providing good care outcomes for the people who live there. In July 2008 we carried out an Annual Service Review (ASR) of Westbourne which involved us reviewing all the information we had received about Westbourne since the last key inspection. The assessment of Westbourne following the ASR was that it continued to provide good care outcomes. This key inspection was unannounced and was carried out by one inspector. Where this report refers to we it recognises that it is written on behalf of the Care Quality Commission. The inspection started early in the morning, before the night staff had finished and continued for six hours. This gave us the opportunity to observe the early morning Care Homes for Older People Page 6 of 26 routine of the home as people were being helped to get up and ready for the day ahead. It also enabled us to observe both the breakfast and lunchtime routine of the home. We were able to talk to some of the people who live in the home and to visitors to the home on the day, including health care professionals. We talked to staff and had very positive discussions with the deputy manager who was in charge of the home in the absence of the registered manager. During the inspection we were also able to talk to the providers about their view of the homes performance and their plans for the future. We looked at some key records, including those for staff recruitment, care planning and the administration of medication. We received a number of surveys from people living in the home, relatives carers and advocates, health care professionals associated with the home and also staff working at Westbourne. The views expressed have been taken into account when drawing up this report. The home also sent us an Annual Quality Assurance Assessment or AQAA. The AQAA is a self assessment document which assesses the care outcomes for people living in the home and which also includes some useful statistical information, for example about staff training and complaints. What the care home does well: What has improved since the last inspection? What they could do better: The home identifies the need to sustain quality as its priority and mentions for example the need to make information about the home available in large print formats to improve access for people for whom that would be helpful. There are no requirements made following this inspection and that reflects what was an overwhelmingly positive process. Over the past four years in particular, Westbourne has been set on a path of significant, incremental improvement that has seen it progress to the new assessment that it provides excellent care outcomes for the people who live there. This has only been achieved through the dedication and hard work of all the people associated with the home, including the proprietors. The challenge for the future is to both maintain, sustain and take forward the standard of care outcomes achieved. Care Homes for Older People Page 8 of 26 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering Westbourne as a home for themselves or someone they are responsible for can be assured that they will be provided with the information they need to help them make a well informed decision. They can also be confident that a robust assessment process will ensure that only those people whose needs can be met will be admitted into the home. Evidence: When we asked people who live in Westbourne if they had received enough information before they moved in to help them decide if this was the right place for them, 100 of those who responded in surveys indicated that they did. They also indicated that they had all received a contract setting out the terms and conditions applying to their stay in the home. In their AQAA the home indicate that the information provided to people enquiring about a possible move to Westbourne is available in audio format to help make the Care Homes for Older People Page 11 of 26 Evidence: information accessible. When we spoke to someone who had only recently moved into Westbourne, they told us about the visits they and their relatives had made to the home before making a decision and how they were given a choice of room and an opportunity to meet the manager and her staff. When we looked at the care plans for people who have recently moved into Westbourne we saw evidence of a robust and thorough pre-admission assessment process that should ensure that a prospective residents needs are identified and that the home is able to meet them satisfactorily. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Westbourne can be confident that they will receive effective health and personal care support, that they will be treated with respect and as an individual and that systems and records for medication are accurate and efficient. Evidence: The providers are excellent, caring and professional, They have been outstanding when providing end of life/palliative care and paid particular attention to the individual needs of the resident and family alike, They have an excellent rapport with health professionals and are prompt to report health needs, Provides excellent residential care for residents with supportive and informed staff. Those are all comments made to us by a series of health care professionals associated on a routine basis with the home. The standard of care we observed throughout this inspection was of a high standard and this is reflected in comments made to us by people who live in the home and those who are responsible for them, with 98 of surveys responding always to the question do you receive the care and support you need? 100 of relatives told us that Care Homes for Older People Page 13 of 26 Evidence: the person living in Westbourne for whom they are responsible either always or usually met their care needs and in particular their individual needs. Cheerful atmosphere and caring staff who seem to relate to and care about individual patients was one typical comment received. When we looked at care plans, we found clear evidence that people living in the home are involved both with drawing up and also reviewing their care plans, which shows a positive commitment to maintaining the rights and involvement of people living in Westbourne. The care plans themselves were clear and comprehensive, setting out individual health care needs and how they were to be met in line with individual preferences and choices. The standard of medication records seen was very good. There were no gaps in records, the standard of hygiene was good and there is a robust system of monitoring and checking in place to ensure that if there are any errors made, they can be identified and rectified promptly. It was positive to find two instances when either full or partial self medication was being undertaken by people living in the home, within a risk assessment framework to ensure that this is done safely and effectively. In their AQAA the home indicated that they had introduced a medication communication audit to improve the ability of GPs to maintain up to date records of the medication profile of people living in the home. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Westbourne can be confident that they will be encouraged and helped to exercise choice and control over their lives including their daily activities and meals and that they will be able to maintain contact with the community, family and friends. Evidence: They have an enterprising activities therapist who jollies them up, arranges social events and even takes my friend on trips to the library, which has made an enormous difference to their life. This was a very typically positive comment received about the homes activities from a friend of a person living in Westbourne. The reference to one to one time, for example taking a person to the library is a particular strength of the way activities are focused on individual needs. This was supported by the documentation seen, which includes personal preferences, life history and details specific to the individual which are used to inform the pattern of day to day activities and routines, including meals, meal times and food preferences. The recent addition of extra support staff to relieve care staff of some of the routine domestic tasks they used to have to do has enabled them to devote some more time to individuals living in the home supporting the work of the activities organiser. Care Homes for Older People Page 15 of 26 Evidence: On the day we visited the home there was a church service taking place and sessions of organised activities in the two lounges were also observed. When we received comments from people living in the home in surveys, they were very positive about the activities; They provide regular entertainment and in answer to the question; What does the home do well? Activities during the day, entertainment, BB Qs and afternoon teas were some quite typical comments. When we spoke to the homes activities organiser, they told us that they are engaged in a training programme for people providing activities in residential care settings provided by a nationally recognised specialist organisation for activities. This provides Westbourne with the benefit of a well trained and supported activities staff team, conversant with current best practice in the provision of a varied and stimulating programme of activities for people living there. The home have, for example obtained a WII for interactive activities for people in the home and have also made a lap-top with internet access available for the use of people living in the home so that they can keep in touch with friends and relatives via e-mail. We saw records of regular residents and relatives meetings and all of those relatives spoken to or surveyed told us that the home communicates with them appropriately and that they are encouraged to maintain contacts with the people living in Westbourne. We observed both breakfast and lunch during our visit and in both cases we saw that choices were on offer and that people were being assisted where necessary in a respectful way, with no evidence of being hurried or pressured in any way. The dining room in particular is well laid out and attractively furnished and there are alternative dining facilities available in the conservatory or people can take their meals in their own rooms if they prefer. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Westbourne can be confident that they will be protected from abuse and that they are able to make a complaint if they wish to do so and that it will be dealt with appropriately. Evidence: The homes complaints policy and procedure is included in the material provided to all people living in the home and is also clearly displayed in the home. In their AQAA the home tell us that they will be providing a large print version of the policy and procedure to ensure it is clear and readable for everyone that needs to see it. When we surveys people living in the home and those responsible for them they all confirmed that they knew how to make a complaint if they needed to. In their AQAA the home told us that there have been three complaints in the past twelve months all of which are now resolved. When we looked at complaints records we could see that complaints are recorded and outcomes noted. When we looked at staff training records we could see that training in the safeguarding of vulnerable adults has already been undertaken in February and we were told that this will routinely be updated. This means that staff should be aware of what abuse is and what action to take if it is seen or suspected. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living or working in Westbourne can be assured that the environment is safe, clean and well-maintained. Evidence: When we walked round the home we did not notice any areas where there were unpleasant smells and the home appeared clean, tidy and well-maintained. We did find one door guard that was emitting an irritating warning signal as the battery was low. This was addressed during the inspection. When we were able, with their permission, to see the bedrooms of people living in the home we found that they had been able to personalise them with their own furniture, pictures and ornaments, so that they became their space with familiar things around them reflecting their interests and personalities. I have a lovely room, I can see what is going on outside and they keep it lovely and clean was one typical comment. There were builders on site throughout this inspection completing the extension and conversion of one downstairs room into an en suite bedroom in place of one without an en suite. The kitchen has been refitted with commercial standard and quality of furniture and equipment and the home has been rated as good by the local environmental health inspectorate. Care Homes for Older People Page 18 of 26 Evidence: One of the two front lounges has been designated as a quiet area, without any television and this was seen to be popular with those people living in the home who prefer to sit and read or knit and talk among themselves or simply sit and watch what is going on. The home have responded to historic concerns about care staff having to carry out domestic housekeeping duties by taking on extra ancillary staff. This has given care staff more time to concentrate on care and has overall, improved the operation of the home. The front of the home outside has been cleared of some trees and better provision made for people to sit outside and enjoy the fresh air. As part of the current building programme, the rear garden is being redeveloped, with an enlarged patio area adjacent to and accessible from the dining room, with ramped access down to the garden, which we were told is to include a sensory raised bed for people living in the home to enjoy. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Westbourne can be assured that they are protected by the recruitment policies and procedures followed by the home and that there are sufficient numbers of care staff with the training and skills required to meet their care needs. Evidence: The carers are wonderful was one comment made by a person living in the home and that view was supported by everyone that we spoke to or received surveys from. One relative told us; Of all the residential homes I have visited Id probably choose to go here because the staff seem to really care. Supportive and informed staff was the comment of one health care professional and another noted; The district nursing team have visited patients here at least a few times each week for many years and have a huge amount of trust in the manager and staff who always act on any advice from our services. When we spoke to relatives or received survey responses from them, the only slightly negative comment was that staff are kept very busy and that some more staff would always be helpful. The home have in part attempted to address this by employing more ancillary staff to relieve care staff of any domestic duties, which frees up more time to provide one to one care. Care Homes for Older People Page 20 of 26 Evidence: When we looked at staffing rotas, they seemed to be appropriate and to provide sufficient suitably trained and qualified staff in the home at all times. The appointment of a new head of care has helped the deputy manager and the senior care staff to carry out their duties more effectively. When we spoke to staff they were unfailingly enthusiastic about the home, their training and the support they get from the extensive management structure. We are a team and We are proud of what we do were constant refrains from the staff and throughout this inspection we were able to see this in practice. One resident, speaking of the deputy manager said; She is like a live-wire, always on the go When we looked at training records they were well completed and provided good evidence that care staff have the training, skills and experience needed to help them achieve good and safe care outcomes for people living in the home. The AQAA informs us that over 95 of car staff now have NVQ at at least level 2, with some holding level 3 and others level 4. This is an notable achievement and has been helped by a relatively small turnover of staff which also benefits people living in the home as care staff are familiar with and to them. Recruitment records seen for some recently recruited staff included the checks and information needed to ensure that people living in the home are safeguarded from the employment of obviously unsuitable people. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Westbourne is well managed and has an effective administrative and management support structure in place. This helps ensure that people who live in the home receive a high level of care within a safe environment provided by well trained and motivated staff. Evidence: When we spoke to people living in the home, to care staff, relatives, visitors and health care professionals associated with the home, they were all very positive about the way that the home is run and managed and about the manager and her team. We found in talking prior to the inspection with the manager and during it with her management team and the providers that the management of the home is wellresourced and that the manager feels she is given the support and assistance she requires by the providers to help her direct and manage the activities and development of the home effectively. Care Homes for Older People Page 22 of 26 Evidence: The home has a well-developed management structure with a deputy manager, head of care and senior carers as well as care workers. This structure has improved the day to day operation of the home quite significantly and this has been recognised by care staff and senior carers as well as by people living in the home and those who regularly visit the home. The manager is well qualified as are her senior management team and there is a good level of knowledge at all levels of recent developments in care provision, including for example implications of the new mental capacity regulations and the requirements around any deprivation of liberty issues that may be assessed. Staff supervision was well documented and is supported by what care staff acknowledged was an open door management approach, which enables them to raise any issues or concerns they may have, with the manager as they arise. The AQAA was well completed and was found to be accurate and realistic when measured against what was found and seen during the inspection visit. This, together with the quality assurance process that is in place provides confidence that the home is genuinely committed to a process of improvement. When we looked at the system of risk assessment that is in place we found that it is thorough, comprehensive and subject to regular review in order to make sure it remains relevant and up to date and continues to protect people who live in the home from avoidable risks whilst maintaining their Independence and autonomy. This was evidenced for example by the risk assessments completed in respect of those people who live in the home who are capable of and want to administer either fully or in part their own medication. When we spoke to one member of the care staff team who is pregnant, we found that risk assessments have been completed and that her duties have been restricted to ensure her health and well-being are safeguarded. We have previously found that the system of recording in respect of any monies held by the home on behalf of people living there is effective and subject to routine checks and audit. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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